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Marginal Redness and Bleeding following Definitive Crown: Ideas?

Last Updated: Apr 25, 2018

I have been doing quite a few extraction and immediate implantation cases with socket preservation using collagen followed by immediate fixed implant provisional. I normally do this for upper incisors or upper premolars. Most of these extracted teeth have acute or chronic peri-apical lesions. Once done, It all goes very well and after 3 – 4 months I switch to a porcelain crown. I have noticed that on 3 cases of mine there is redness and some bleeding developing around the buccal margin. At first I thought there might be a different fit of the porcelain crown to the provisional acrylic crown leaving a space, so I added porcelain to maybe fill the gap and tighten the fit at the gingival margin. But, the bleeding persists. There is no swelling or pain, just slight bleeding. The hygiene is otherwise good. Can™t make heads or tails of this. Any ideas? Many thanks.

6 Comments on Marginal Redness and Bleeding following Definitive Crown: Ideas?

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HAMIDREZA ziaee

4/25/2018

i think the cause of bleeding is mucositis

LSDDDS

4/25/2018

Check for toothbrush abrasion, overzealous brushing Crown contour not deflecting food properly or retaining plaque Crown margin too far under gingiva Retained cement Open crown margin or poor fit Insufficient attached gingiva Noxious habit Abutment not screwed down sufficiently or poor fit Thatâ€™s all I can think of My bet on TB over use

SMSDDSMDT

4/26/2018

UHM?? How was the definitive crown design communicated to the lab??

Jean Paul Demajo

4/26/2018

Just normal impression with extra light silicone around the impression coping and heavy body to fill the tray. I know there is a more precise way of transferring the gingival contour but it was pretty dry and even and precise. Do you believe there might be a space below the guy line with plaque build-up ? I even added porcelain and it had a tighten fit but 3wks later there was still slight bleeding. ???!!!!!

elle

4/27/2018

This is happening to me with upper front crowns. Please comment some more. My periodontist did gum lengthening on 2 front teeth to improve esthetic zone from botched implant by another dentist who shouldn't be practicing. This is where the problem lies most, with the gum lengthened crowns, and a bit on the next front tooth. I have had all my teeth done with crowns and some veneers. Excellent hygiene, no problem on any other crowns, Dentist and perio don't know why it is not healing. Tired of hearing that they don't know and don't refer me to someone who knows. If they don't know then they should find out, don't you think? Can't just leave me in the lurch.

Dr. Bill Woods

5/21/2018

If not retained cement, I would bet on an open margin. Were verification radiographs of the impression coping and crown seat? Just s thought.

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